scholarly journals Diabetic Peripheral Neuropathy and Urological Complications in Type 1 Diabetes: Findings From the Epidemiology of Diabetes Interventions and Complications Study

2021 ◽  
Author(s):  
Rodica Pop-Busui ◽  
Barbara H. Braffett ◽  
Hunter Wessells ◽  
William H. Herman ◽  
Catherine L. Martin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Duration ◽  
Urinary Tract Symptoms ◽  
Urological Complications ◽  
Drinking Status ◽  
Michigan Neuropathy Screening Instrument ◽  
Diabetes Interventions

Objective: <br>To evaluate associations between diabetic peripheral neuropathy (DPN) and urological complications in men and women with type 1 diabetes. <br>ResearchDesignandMethods: <br>Measurements of DPN at EDIC years 1, 13/14 and 17 and urological complications at EDIC year 17 were examined in 635 men (mean age 51.6 yrs, diabetes duration 29.5 yrs) and 371 women (mean age 50.6 yrs and diabetes duration 29.8 yrs) enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. DPN was defined by symptoms, signs and abnormal electrophysiology, or by abnormal Michigan Neuropathy Screening Instrument (MNSI) examination or questionnaire scores. <br>Results: <br>Erectile dysfunction (ED) in combination with lower urinary tract symptoms (LUTS) was reported in 15% of men, and female sexual dysfunction (FSD), LUTS and urinary incontinence (UI) in 16% of women. When controlling for age, drinking status, BMI, depression, DCCT/EDIC time-weighted mean HbA1c, microalbuminuria, hypertension, triglycerides and statin medication use, men with confirmed DPN at EDIC year 13/14 had a higher odds of ED/LUTS at year 17 compared to men without DPN (OR=3.52 95% CI 1.69,7.31). Men with DPN based on abnormal MNSI examination or questionnaire scores had significantly higher odds of ED and LUTS at year 17 than men without DPN at all time points. There were no significant differences in DPN between women reporting both FSD and LUTS/UI compared to those without FSD or LUTS/UI at EDIC year 17. <br>Conclusions: <br>In long-standing T1D, DPN is associated with the later development of urological complications in men. <b></b>

scholarly journals Diabetic Peripheral Neuropathy and Urological Complications in Type 1 Diabetes: Findings From the Epidemiology of Diabetes Interventions and Complications Study

2021 ◽  
Author(s):  
Rodica Pop-Busui ◽  
Barbara H. Braffett ◽  
Hunter Wessells ◽  
William H. Herman ◽  
Catherine L. Martin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Duration ◽  
Urinary Tract Symptoms ◽  
Urological Complications ◽  
Drinking Status ◽  
Michigan Neuropathy Screening Instrument ◽  
Diabetes Interventions

Objective: <br>To evaluate associations between diabetic peripheral neuropathy (DPN) and urological complications in men and women with type 1 diabetes. <br>ResearchDesignandMethods: <br>Measurements of DPN at EDIC years 1, 13/14 and 17 and urological complications at EDIC year 17 were examined in 635 men (mean age 51.6 yrs, diabetes duration 29.5 yrs) and 371 women (mean age 50.6 yrs and diabetes duration 29.8 yrs) enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. DPN was defined by symptoms, signs and abnormal electrophysiology, or by abnormal Michigan Neuropathy Screening Instrument (MNSI) examination or questionnaire scores. <br>Results: <br>Erectile dysfunction (ED) in combination with lower urinary tract symptoms (LUTS) was reported in 15% of men, and female sexual dysfunction (FSD), LUTS and urinary incontinence (UI) in 16% of women. When controlling for age, drinking status, BMI, depression, DCCT/EDIC time-weighted mean HbA1c, microalbuminuria, hypertension, triglycerides and statin medication use, men with confirmed DPN at EDIC year 13/14 had a higher odds of ED/LUTS at year 17 compared to men without DPN (OR=3.52 95% CI 1.69,7.31). Men with DPN based on abnormal MNSI examination or questionnaire scores had significantly higher odds of ED and LUTS at year 17 than men without DPN at all time points. There were no significant differences in DPN between women reporting both FSD and LUTS/UI compared to those without FSD or LUTS/UI at EDIC year 17. <br>Conclusions: <br>In long-standing T1D, DPN is associated with the later development of urological complications in men. <b></b>

scholarly journals An increased skin microvessel density is associated with neurovascular complications in type 1 diabetes mellitus

2019 ◽  
Vol 16 (6) ◽  
pp. 513-522 ◽  
Author(s):  
Anna Adamska ◽  
Stanislaw Pilacinski ◽  
Dorota Zozulinska-Ziolkiewicz ◽  
Agnieszka Gandecka ◽  
Agata Grzelka ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Peripheral Neuropathy ◽  
Confidence Interval ◽  
Autonomic Neuropathy ◽  
Microvessel Density ◽  
Diabetic Peripheral Neuropathy ◽  
Odds Ratio ◽  
Diabetes Duration ◽  
Cardiac Autonomic Neuropathy

The aim of this study was to assess the blood vessel density and maturity in the skin of adults with type 1 diabetes in relation to the presence of late neurovascular complications. We included 148 patients (87 men) with a median (interquartile range) age of 41 (31–49) and median diabetes duration of 21 (17–30) years. Microvessel (CD133, CD34, CD31 and von Willebrand factor) markers were evaluated by indirect immunohistochemistry assay in material from a skin biopsy. Diabetic retinopathy was diagnosed using direct ophthalmoscopy, and diabetic kidney disease was estimated in people with increased albuminuria and a 10-year duration of diabetes or evidence of diabetic retinopathy . Diabetic peripheral neuropathy diagnosis was based on Toronto definition, cardiac autonomic neuropathy on validated ProSciCard III program. Microvessel density, assessed by CD34 and CD133, was significantly higher in patients with cardiac autonomic neuropathy [160 (125–175) vs 121 (100–154)/1 mm2, p = 0.001 and 92 (83–104) vs 79 (63–92)/1 mm2, p = 0.007, respectively] and CD34 in patients with diabetic peripheral neuropathy [135 (106–168) vs 121 (95–145)/1 mm2, p = 0.018], as compared with subjects without complications. In multivariate logistic regression, density of CD34 and CD133 positive vessels was associated with presence of cardiac autonomic neuropathy [odds ratio 1.016 (95% confidence interval: 1.002–1.029), p = 0.019 and odds ratio 1.037 (95% confidence interval: 1.008–1.067), p = 0.011, respectively]. It was independent from age, sex, diabetes duration, smoking status, body mass index and HbA1c value. Density of CD34 positive vessels was also associated with diabetic peripheral neuropathy, independently from sex and diabetes duration [odds ratio 1.009 (95% confidence interval: 1.001–1.020), p = 0.037]. Skin microvessel density is increased in adults with clinical evidence of neurovascular complications of type 1 diabetes. This is associated with predominance of the vessels of low maturity.

‘Living with challenges in the shadow of diabetes’: An interview study among adults with diabetic peripheral neuropathy

2019 ◽  
Vol 40 (2) ◽  
pp. 73-80
Author(s):  
Ylva Wessman ◽  
Christel Bahtsevani
Keyword(s):  
Type 1 Diabetes ◽  
Content Analysis ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Qualitative Content Analysis ◽  
Related Complication ◽  
Changes Over Time ◽  
Diabetes Related Complication ◽  
Over Time

Diabetic peripheral neuropathy is a diabetes-related complication with vague and progressive symptoms with few available treatments. The aim of this study was to describe the experiences of diabetic peripheral neuropathy among adults living with type 1 diabetes. Twelve interviews were performed and qualitative content analysis was used. The overarching theme ‘living with challenges in the shadow of diabetes’ substantiated by the categories ‘pay attention to changes over time’, ‘frequent needs to facilitate living’ and ‘burdens to manage’ represents a daily awareness of the complication where autodidactic strategies were implemented. The conclusion indicates that it might be beneficial if nurses in diabetes care initiate an open-minded dialogue with adults with diabetic peripheral neuropathy to highlight their experiences and to discuss further strategies to facilitate living.

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